Internal Medicine Unit, Pavullo Hospital, Azienda USL, Modena, Italy.
Curr Pharm Des. 2020;26(32):3915-3927. doi: 10.2174/1381612826666200417142444.
Nonalcoholic fatty liver disease (NAFLD) embraces histopathological entities ranging from the relatively benign simple steatosis to the progressive form nonalcoholic steatohepatitis (NASH), which is associated with fibrosis and an increased risk of progression to cirrhosis and hepatocellular carcinoma. NAFLD is the most common liver disease and is associated with extrahepatic comorbidities including a major cardiovascular disease burden. The non-invasive diagnosis of NAFLD and the identification of subjects at risk of progressive liver disease and cardio-metabolic complications are key in implementing personalized treatment schedules and follow-up strategies. In this review, we highlight the potential role of ultrasound semiquantitative scores for detecting and assessing steatosis severity, progression of NAFLD, and cardio-metabolic risk. Ultrasonographic scores of fatty liver severity act as sensors of cardio-metabolic health and may assist in selecting patients to submit to second-line non-invasive imaging techniques and/or liver biopsy.
非酒精性脂肪性肝病(NAFLD)涵盖了从相对良性的单纯性脂肪变性到进展性非酒精性脂肪性肝炎(NASH)的组织病理学实体,后者与纤维化和进展为肝硬化和肝细胞癌的风险增加有关。NAFLD 是最常见的肝脏疾病,与肝外合并症有关,包括心血管疾病负担的增加。NAFLD 的非侵入性诊断以及识别进展性肝病和代谢性心血管并发症风险的患者是实施个性化治疗计划和随访策略的关键。在这篇综述中,我们强调了超声半定量评分在检测和评估脂肪变性严重程度、NAFLD 进展和代谢性心血管风险方面的潜在作用。肝脏脂肪变性严重程度的超声评分可作为代谢性心血管健康的传感器,并可能有助于选择需要进行二线非侵入性成像技术和/或肝活检的患者。